Reliability of Static and Dynamic Balance Tests and Their Interrelationships in Children With Cochlear Implants

Children with cochlear implants are at increased risk of vestibular dysfunction and balance impairments, yet the reliability of commonly used static and dynamic balance assessments has not been thoroughly evaluated in this population. This study aimed to assess the reliability of static balance tests (single-leg stance test [SLST] and tandem Romberg test [RT], performed with eyes open [EO] and eyes closed [EC]), dynamic balance tests (timed up and go test [TUG] and figure-of-eight walk test [F8WT]) and Paediatric Balance Scale (PBS), which includes both static and dynamic components, and to examine relationships among these tests in children with cochlear implants.

Sixty-two children with cochlear implants, aged 7-13 years, performed all the balance tests. Two test sessions were conducted by the same physiotherapist on separate days within the same week.

All balance tests demonstrated excellent intrarater reliability, with ICCs ranging from 0.906 to 0.985. The PBS showed excellent internal consistency (Cronbach's alpha = 0.88). Strong correlations were observed among static balance tests, and moderate correlations were found among dynamic tests. Correlations between static and dynamic tests were weaker. The PBS correlated strongly with static tests and moderately with dynamic tests.

All tests demonstrated excellent intrarater reliability, with PBS also showing excellent internal consistency. While these findings confirm the reliability of the assessments, validity was not examined and should be addressed in future research to establish their clinical utility in this population.